milwaukeesend 10 09 2009
DESCRIPTION
Presentation by Dr. C. Martin Harris of Cleveland Clinic. Dr. Harris came to Milwaukee on October 9th to provide the information in this presentation.TRANSCRIPT
EMR Use in the Age of Healthcare Reform
C. Martin Harris, M.D.Chief Information Officer, Cleveland ClinicExecutive Director, eCleveland Clinic
• On February 17, President Barack Obama signed the $787 billion American Recovery and Reinvestment Act of 2009.
• The “Act” includes $140 billion for “comprehensive healthcare reform.”
• A net overall investment of $19.2 billion, will be used to promote Health Information Technology adoption and implementation.
• Physicians and hospitals are eligible to receive portions of these funds based on:
– Having an integrated electronic medical record system in place by January 1, 2011.
– Demonstrating EMR “meaningful use”
New Opportunities: HIT Stimulus
American Reinvestment and Recovery Act HIT Directives
Framework(HIT Adoption, Quality
Management, and Interoperability)
Secretary, Health and Human
Services
HIT Policy Committee
HIT Standards Committee
Definition of Meaningful Use
StandardsDefinition
MeasuresDefinition
Stimulus-related (Funding)
• HIT-related Programs
– Definition of “Meaningful Use”
An enterprise-wide eHealth services program that is presently
changing the paradigm of medical practice by applying Health
IT solutions to improve patient care, enhance operational and
administrative efficiency, reach out to patients and
community physicians, and create new knowledge through
ongoing research and education initiatives.
eAnalytics and Research:
Research Standardization
eAnalytics and Research:
Research Standardization
Dr.Connect:Improved
Communication; Improved Care
Dr.Connect:Improved
Communication; Improved Care
MyPractice:Electronic Medical
Record System
MyPractice:Electronic Medical
Record System
MyPractice●
Community
MyPractice●
Community
eHealth ServiceseHealth Services
VirtualVisit:Patient/Physician
Interaction Globally
VirtualVisit:Patient/Physician
Interaction Globally
MyConsult:Your First Choice for
a Second Opinion
MyConsult:Your First Choice for
a Second Opinion
MyChart:Your Personal
Health Connection
MyChart:Your Personal
Health Connection
MyMonitoring:Ongoing Condition
Reporting from Home
MyMonitoring:Ongoing Condition
Reporting from Home
ProvidersProviders PatientsPatients
MyPractice:Electronic Medical
Record System
MyPractice:Electronic Medical
Record System
MyPractice Electronic Medical Record
Patients
Front Desk
NursesPhysicians
Schedulers
Residents
Researchers
Physicians = 6,004Residents / Fellows = 850Pharmacists = 364Other End Users = 38,608Patients in the EMR = 5,707,792
Prescriptions = 42,472,788Orders = 126,649,261Encounters = 24,174,250Total Results = 484,072,179
Cleveland Clinic User and Encounter Statistics(Through August, 2009)
Ambulatory Functionality• Messaging
• Schedule
• Results
• Documentation
• Physician Order Entry
• Best Practice Alerts
Electronic Medical Record Electronic Medical Record
Inpatient Functionality• Inpatient census
• All results
• Medication administration record
• Vital signs and I&O
• Documentation
• Computerized PhysicianOrder Entry (CPOE)
Electronic Medical Record Electronic Medical Record
Results
On-Line Documentation
Computerized Physician Order Entry
DRUGS:COUMADIN TABLET 2 MG POZOLOFT 50 MG POSIGNIFICANCE LEVEL. Very High
DRUGS:COUMADIN TABLET 2 MG POZOLOFT 50 MG POSIGNIFICANCE LEVEL. Very High Can override and
accept the interaction
Can override and accept the interaction
Drug Interaction Alert
Age, Gender, and Diagnosis SpecificHealth Maintenance Alerts
eAnalytics and Research:
Research Standardization
eAnalytics and Research:
Research Standardization
Dr.Connect:Improved
Communication; Improved Care
Dr.Connect:Improved
Communication; Improved Care
MyPractice:Electronic Medical
Record System
MyPractice:Electronic Medical
Record System
MyPractice●
Community
MyPractice●
Community
eHealth ServiceseHealth Services
VirtualVisit:Patient/Physician
Interaction Globally
VirtualVisit:Patient/Physician
Interaction Globally
MyConsult:Your First Choice for
a Second Opinion
MyConsult:Your First Choice for
a Second Opinion
MyChart:Your Personal
Health Connection
MyChart:Your Personal
Health Connection
MyMonitoring:Ongoing Condition
Reporting from Home
MyMonitoring:Ongoing Condition
Reporting from Home
ProvidersProviders PatientsPatients
MyChart:Your Personal
Health Connection
MyChart:Your Personal
Health Connection
MyChart
Patient Services• View medical information
• View health reminders
• View schedule
• Appointment request
• Prescription renewal request
s a l l y i
x
eAnalytics and Research:
Research Standardization
eAnalytics and Research:
Research Standardization
Dr.Connect:Improved
Communication; Improved Care
Dr.Connect:Improved
Communication; Improved Care
MyPractice:Electronic Medical
Record System
MyPractice:Electronic Medical
Record System
MyPractice●
Community
MyPractice●
Community
eHealth ServiceseHealth Services
VirtualVisit:Patient/Physician
Interaction Globally
VirtualVisit:Patient/Physician
Interaction Globally
MyConsult:Your First Choice for
a Second Opinion
MyConsult:Your First Choice for
a Second Opinion
MyChart:Your Personal
Health Connection
MyChart:Your Personal
Health Connection
MyMonitoring:Ongoing Condition
Reporting from Home
MyMonitoring:Ongoing Condition
Reporting from Home
ProvidersProviders PatientsPatients
MyMonitoring:Ongoing Condition
Reporting from Home
MyMonitoring:Ongoing Condition
Reporting from Home
eEnabled Chronic Care Management Model
Connectivity
eEnabled Chronic Care Management Model
,,,,
,
Patient’s Blood Pressure Measures from Home
MyPractice: Physician Results View
Connectivity
MyChart
eEnabled Chronic Care Management Model
Dear Patient,I recommend the following:Begin spironolactone 25mg once daily. I sent this as a secure ePrescription to your preferred pharmacy.Stop Norvasc (amlodipine), but do not discard.Decrease potassium to 20mEq once dailyStop by the lab for blood potassium test 2-3 weeks after making these changes.
Message me if you have additional questions.
eAnalytics and Research:
Research Standardization
eAnalytics and Research:
Research Standardization
Dr.Connect:Improved
Communication; Improved Care
Dr.Connect:Improved
Communication; Improved Care
MyPractice:Electronic Medical
Record System
MyPractice:Electronic Medical
Record System
MyPractice●
Community
MyPractice●
Community
eHealth ServiceseHealth Services
VirtualVisit:Patient/Physician
Interaction Globally
VirtualVisit:Patient/Physician
Interaction Globally
MyConsult:Your First Choice for
a Second Opinion
MyConsult:Your First Choice for
a Second Opinion
MyChart:Your Personal
Health Connection
MyChart:Your Personal
Health Connection
MyMonitoring:Ongoing Condition
Reporting from Home
MyMonitoring:Ongoing Condition
Reporting from Home
ProvidersProviders PatientsPatients
MyPractice●
Community
MyPractice●
Community
Connectivity / Interoperability
MyPractice Community database pre-loaded with:• 100+ million data elements • Insurance information for all major payors
MyPractice Community connected to:• Laboratories
– Cleveland Clinic Health System– Quest Diagnostics
• Retail Pharmacies• Acme ● Sam’s Club• CVS ● Walgreens• Giant Eagle ● WalMart• RITE AID
• Transcription Companies• MedQuist ● Precis ● Premier• Spheris ● Cymed ● Chase
1. Independent Physician’s Office
2. Independent commercial pharmacy,labs, and patient at home
3. Cleveland Clinic Ambulatory sites
4. Cleveland Clinic Inpatient
Meaningful UseOperating Model
Operating Model
Process to Achieve Meaningful Use
Objectives
“The ultimate vision is one in which all patients are fully engaged in their healthcare, providers have real-time access to all medical
information and tools to help ensure the quality and safety of the care provided while
also affording improved access and elimination of health care disparities.”
“Meaningful Use: A Definition” Recommendations from the Meaningful Use Workgroup
to the Health IT Policy Committee June 16, 2009